• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.153-169
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• 1996

This study was designed to identify, describe and classify orientations of cancer patient's family members to death and to identify factors related to their attitudes on death. Death to the male is understood as a comprehensive system and believed to be highly subjective experience. Therefore attitude on death is affected by personalities. As an attempt to measure the subjective meaning toward death, the unstructured Q-methodology was used. Korean Death Orientation Questonaire prepared by Kim was used. Item-reliability and Sorting-reliability were tested. Forty five cancer patients' family members hospitalized in one university medical center in Seoul were sampled. Sorting the 65 Q-itmes according to the level of personal agreement ; A forced normal distribution into the 11 levels, were carried out by the 45 P-samples. The demographic data and information related to death orientation of the P-sample was collected through face to face in depth interviews. Data was gathered from August 30 till September 22, 1995. The Z-scores of the Q-items were computed and principal component factor analysis was carried out by PC-QUANL Program. Three unique types of the death orientation were identified and labeled. Type I consists of twenty P-samples. Life and death was accepted as people's destiny, They firmly believed the existence of life after life. They kept aloof from death and their concern was facing the and of the life with dignity, They were in favor of organ donation. Type II consists of Nine P-Samples. They considered that death was the end of everything and did not believed the life after life. They were very concerned about the present life. Type III consists of Sixteen P-samples. They regarded the death as a natural phenomena. And they considered that the man is just a traveller and is bound to head for the next life which is believed to be free of agony, pain or darkness. They neither feared death nor its process. Their conserns were on the activities to prepare themselves for the eternal-life after death. Thus, it was concluded that there were three distinctiven type of attitudes on death among cancer patient family members, and their death attitudes were affected by demographic and socio-cultural factors such as sex, education, and religion.

• Journal of Auto-vehicle Safety Association
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• v.10 no.4
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• pp.7-12
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• 2018

Injury mechanisms of lower extremity injuries in motor vehicle accidents are focused on fractures, sprains, and contusions. The purpose of this study is to evaluate the analysis of lower extremity injury mechanism in occupant motor vehicle accident by using Hospital Information System (HIS) and reconstruction program, based on the materials related to motor vehicle accidents. Among patients who visited the emergency department of Wonju Severance Christian Hospital due to motor vehicle accidents from August 2012 to February 2014, we collected data on patients with agreement for taking the damaged vehicle's photos. After obtaining the verbal consent from the patient, we asked about the cause of the accident, information on vehicle involved in the accident, and the location of car repair shop. The photos of the damaged vehicle were taken on the basis of front, rear, left side and right side. Damage to the vehicle was presented using the CDC code by analytical study of photo-images of the damaged vehicle, and a trauma score was used for medical examination of the severity of the patient's injury. Among the 1,699 patients due to motor vehicle crashes, 88 (5.2%) received a diagnosis of lower extremity fracture and 141 (8.3%) were the severe who had ISS over 15. Nevertheless during 19 months for research, it was difficult to build up in-depth database about motor vehicle crashes. It has a limitation on collecting data because not only the system for constructing database about motor vehicle crash is not organized but also the process for demanding materials is not available due to prevention of personal information. For accurate analysis of the relationship between occupant injury and vehicle damage in motor vehicle crashes, build-up of an in-depth database through carrying out various policies for motor vehicle crashes is necessary for sure.

• Journal of Korean Academy of Dental Administration
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• v.7 no.1
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• pp.39-43
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• 2019

Smartphone usage has become so common that it has reached 2 billion people in the last year. As a result of this, hospitals have started making use of smartphones at various medical sites and research services for patients. This study aimed to establish support for developing a long distance program for patients with implants who have difficulty visiting clinics or with busy modern lives, by using smartphones for oral hygiene management instruction. The data were collected for 12 weeks, from July 24 to October 21, 2015, for patients who agreed to participate in the study. Although the subjects found the process of transferring photos via smartphone to be cumbersome (75%), the satisfaction level of the oral hygiene management program was excellent for all participating patients, and they all wanted to continue with further management using this process. The results from the phone satisfaction survey showed that oral hygiene self-management after oral hygiene control training by smartphones was mostly equal to previous habits (87.5%) or had partially increased but had not decreased. The need for data on more varied age groups and the issues of protecting the security of personal information on smartphones require further study. However, our study confirmed the efficacy of using electronic media (smartphones) for oral hygiene management in patients with a dental implant due to their improvement of oral hygiene performance as evidenced by less bleeding from probing on post-program visit.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.169-191
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• 2002

As the tendency of the society is centralized into consumers and services, patients are getting to ask better medical services. The consumers influenced from various social surroundings became to have some expectation of nursing service. Compared with their expectation, the quality of the services which they virtually get may be recognized and evaluated. So it is necessary to know exactly what the consumers want in nursing services. The purpose of this study is to examine the determinants which can evaluate the quality of nursing services by researching into consumers' expectation and perception of the nursing services depending on the consumer-oriented attributions on the basis of the model of SERVQUAL. 1,144 of outpatients were selected as the subjects for this research. They used to continuously visit the same hospital after being hospitalized and nursed in 9 hospitals randomly selected among the second-level medical organizations in Seoul from January to February, 2001. The collected data are analyzed into the Descriptive Statistics, t-test, GLM and Multiple Regression through the SAS program. Delphi was used for the research tool and the results of the research are as follows; the determinants in evaluating the quality of nursing services consist of 5 categories such as Tangibility, Reliability, Responsiveness, Assurance, Empathy. The values of Cronbach' $\alpha$ appeared to be 0.96 in the expectation of nursing services, 0.94 in the perception of nursing services and 0.96 in the importance of nursing services. The determinants in the expectation of nursing services were ranged in the order of Assurance, Empathy, Reliability, Responsiveness and Tangibility. And those in the perception of nursing services were in the order of Assurance, Empathy, Reliability, Tangibility and Responsiveness. Those in the importance of nursing service were in the order of Empathy, Assurance, Reliability, Tangibility and Responsiveness. Finally, those in the quality of nursing service were in the order of Tangibility, Responsiveness, Empathy, Reliability and Assurance. Each expectation of nursing services appeared different depending on the subjects' age, gender, clinical department and reason for hospitalization. The hypothesis examined in this research shows that the group having higher personal needs shows meaningful differences in the expectation of nursing services, and the subjects who have had external communication show higher perception of nursing service than uncommunicative ones. After all, we can see that the statistical differences in the perception of nursing services depend on whether the subjects have external communications or not. The determinants in the expectation of nursing services can explain the quality of nursing service up to 14.96%. The statistically meaningful determinants in the expectation could be arranged in the order of Reliability, Assurance and Tangibility. And the more expectation brings about the lower evaluation of the quality of nursing services. The determinants in the perception of nursing service can explain the quality of nursing services up to 29.85%. The statistically meaningful determinants in the perception could be arranged in the order of Responsiveness, Reliability, Tangibility, Empathy, and Assurance. And the more perception brings about the higher evaluation of the quality of nursing services. According to the result of the above research, I would like to propose as follows. As long as this research is oriented to get knowledge of the consumer-oriented nursing services, it should be continued to draw the other elements determining the quality of the nursing services. Furthermore, this research is based upon the Parasuraman, A., et al.'s SERVQUAL Model(1991), which deals only expectation, perception and quality of consumer-oriented nursing services, so it will be necessary to inspect and verify it through the other models containing the offerers of nursing services in the future. On the other hand, as this research evaluates the actual quality of nursing services based on the expectation and perception of nursing services, it can be utilized as fundamental data to develop the marketing strategies and to estimate the qualities as well. I hope this research will be periodically estimated to be the useful data to develop the marketing strategies in the nursing service area.

• Korean Journal of Occupational Health Nursing
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• v.4
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• pp.5-29
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• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Imaging Science in Dentistry
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• v.36 no.1
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• pp.49-54
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• 2006

Purpose : To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. Materials and Methods : One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side. The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. Results : There were no statistically significant differences between the direct measurements and those using the 3D images (p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. Conclusion : The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissues thickness more easily in forensic science and anthropology.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.4
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• pp.541-557
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• 2003

Purpose: This descriptive study was designed to explore the clinical nurse's ethical value regarding human life. Method: Data were collected from September to October, 2002. Study subjects were 527 clinical nurses working in General Hospital as tertiary located in Seoul. Ethical value was measured with questionnaire developed by researchers and consisted on items regarding ethical value on human life. Result: Among the items, most nurses highly agree with the item, "When a patient requests his/her health care provider to keep his/her personal secret, the health care provider is obliged to do so." and "When a patient asks for information on his/her medicinal and dietary contents, his/her wish must be granted." Most clinical nurses mainly agree with the item. "Health care providers must always be honest to the patient and/or his/her family". However, most nurses disagree with the item, "When a patient is on the verge of death after an accident, it is justifiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them". Most clinical nurses mainly disagree with the items, "When a patient is on the verge of death after an accident, it is justiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them" and "It is justiable that various new ways of treatment should be applied to patient at his/her terminal stage to prolong his/her life, even for the purpose of research". There were significant differences in some items of ethical value according by clinical nurse's age and professional experience, current position, religion, education, marital status, continued education on ethics, and the experience of holing on life saving treatment. Conclusion: It is intensifying the notion of ethical underpinning for human rights, truthfulness is essential to a trust relationship under what circumstances. Also most clinical nurses agree with that It is essential to trust in the nurse-patient relationship, patients have the right to know and it is the ethical thing to do as health care provider.

• Journal of Environmental Science International
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• v.20 no.7
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• pp.799-809
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• 2011

Objectives: This study is aimed at identifying the influential factors on the pulmonary function of ordinary residents in the surrounding areas of Yeosu Industrial Complex. Methods: The PFT (Pulmonary Function Test) was conducted on the target residents numbering 989 people (male 361, female 628). The exposed group (813 people) resided within the radius of 5km from Yeosu Industrial Complex and the control group (176 people) resided in the radius of more than 15 km from May 2007 to November 2007. The survey also took into account other factors including personal characteristics, life habits, respiratory diseases and allergic symptoms, medical histories, and the living environments of the residents in order to further identify influential factors on pulmonary function. Result: When comparing the PFT values of the exposure groups to the control group of the same city, values of the exposure groups were meaningfully lower with an %$FEV_1$ of 107.05% and %FVC of 100.28%. Conversely, the control group reported an %$FEV_1$ and %FVC of 107.26% and 102.85% respectively, indicating that ambient air pollutants reduce lung function. The odds ratio of asthma diagnosis history increased when a subjects residence was close to a heavily trafficked road, traffic amount was huge, a bed was used, and the family had less than four members. However the results were not statistically meaningful. The odds ratios of abnormal pulmonary function were statistically higher among those with asthma(OR=4.29, CI=1.75-10.56), wheezing (OR=2.59, CI=1.24-5.41), and nasal congestion (OR=2.87, CI=1.36-6.08) (p<0.01). The factors affecting $FEV_1$ were symptoms including asthma, passive smoking and allergic eye disease ($R^2$=0.049, p<0.001). For the FVC symptoms including asthma ($R^2$=0.014, p<0.001) were measured. The analysis showed that FVC decreased with increases in $O_3$ and CO(p<0.01). Furthermore, $FEV_1$ decreased with increases in $O_3$(p<0.01). Conclusions: These results will provide preliminary data for establishing responsive measures to protect the health of residents in industrial complexes from air pollution, and to develop lasting environmental health policies.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2003.05a
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• pp.678-681
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• 2003

In this paper, we aims to develop a microcontroll er-based portable pulse oximeter using Compact Flash Interface. First, portable pulse oxineter system is designed to record 2 channel of biosignals simultaneously, including 1 channel of SpO$_2$ and 1 channel of pulse rate. It is very small and portable. Besides, the system makes it possible to measure a patients condition without an additional medical equipment. We tried to solve the problems generated by a patient's motion. That is, we added an analog circuit to a traditional pulse oximeter in order to eliminate the change of the base line. And we used 2D sector algorithm. As present, SpO$_2$ modules are completed. But there are still many further development needed in order to enhance the function. Especially, compact flash interface remains the most to complete. Second, ECG monitoring system uses almost same as present 3-lead ECG system. But we focus on the analog part, especially in filter. The proposed filter is composed of two parts. One is a filter to remove the power-line interface. The other is a filter to remove the baseline drift. A filter to remove the power-line and the baseline drift is necessarily used in the ECG system. The implemented filter have three features; minimizing the distortion in DC component, removing the harmonic component of power-line frequency. Using compact flash interface, we can easily transfer a patient's personal information and the measured signal data to a network based server environment. That means, it is possible to implement a patient's monitoring system with low cost.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.